ER Visits for Preventable Dental Conditions

We assess the extent to which Californians, uninsured and insured, use the ED for ambulatory care sensitive (ACS) dental conditions, i.e. conditions which good outpatient care can prevent the need for ED visits. We used a cross-sectional analysis of emergency department data (2005-2007) to ascertain use of EDs and inpatient hospital services for specific dental conditions identified by ICD-9 codes. There were over 80,000 ED visits for dental ACS conditions in California in 2007, and have increased 16% over the previous three years. Medicaid beneficiaries and the uninsured represent nearly two-thirds of all ED visits. ED visits for dental ACS conditions statewide were more frequent than ED visits for diabetes ACS conditions but less frequent than ED visits for asthma ACS conditions. In some parts of California, visits to the ED for preventable dental conditions are more frequent that visits for other other ambulatory care sensitive conditions. Women had the highest ED visit rates for ACS dental conditions from 2005 to 2007: 364 per 100,000 for ages 18-34. Blacks have a disproportionately high number of ED visits for ACS dental conditions. Conclusion - Good oral health can be maintained with access to primary dental care. Without routine access, however, people may use hospital EDs that are costly and inadequately equipped and staffed to handle dental problems. State Medicaid programs should consider higher reimbursements or other incentives to increase dentists' willingness to treat underserved populations. Furthemore, primary care health practitioners should receive basic training in oral health examination and treatment.